There are many things to know about this bill and how it will effect primary care rates:

The bill does not keep Medicaid rates in parity with Medicare rates. Instead, Medicaid primary care rates will be approximately 87.3% of Medicare rates. This is an improvement from the 73% that was originally part of the budget released in November.

The services eligible for the bump were narrowed, but those most important to primary care physicians were preserved, including office visit codes, vaccinations, preventive visits, counseling, and health risk assessments. ED visits, which were in the original bump, did not receive continued funding

For a variety of reasons, Colorado faces a very difficult budget climate and many factors were not in our favor. It was through months of negotiating and hard work on the part of CAFP leaders, staff and lobbyists that the cut was reduced by half, and one time funding of $55.7 million was secured to achieve the 87.3% rate.

Your current Medicaid reimbursement rates will remain the same through June 30, 2016. Implementation of the new rates will start in the 2016-17 Fiscal Year beginning July 1.

While we are encouraged that in this difficult economic climate additional funding was secured, we recognize that many of your practices could still be negatively effected. Our work on this issue is not done.

We, along with the Joint Budget Committee, recognize that a solution needs to be found to ensure Medicaid rates are permanently on par with Medicare rates.

Our work to achieve this begins now. Over the next year we will identify potential paths to a permanent, full funding source for fair primary care rates.

If you have questions about this outcome we encourage you to reach out to Ryan Biehle, CAFP’s Director of Policy and Government Relations, at ryan@coloradoafp.org or 303-696-6655 ext. 17.

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